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Effect of ultrasound-guided phrenic nerve block on shoulder pain after laparoscopic cholecystectomy-a prospective, randomized controlled trial.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Sep2017, Vol. 31 Issue 9, p3637-3645, 9p, 1 Diagram, 1 Chart, 2 Graphs
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Post-laparoscopic shoulder pain (PLSP) frequently follows a laparoscopic cholecystectomy. A proposed mechanism for PLSP is the irritation or injury of the phrenic nerve by the CO2 pneumoperitoneum during laparoscopic surgery. Here, we investigated whether a phrenic nerve block (PNB), performed under ultrasound guidance, could reduce the incidence and severity of PLSP after laparoscopic cholecystectomy.<bold>Method: </bold>Sixty patients were randomized into two groups, with one group receiving PNB with 4 ml (30 mg) of 0.75% ropivacaine (group P, n = 28) and a control group (group C, n = 32). The existence and severity of PLSP were assessed for 2 days postoperatively. A pulmonary function test (PFT) and diaphragmatic excursion test were performed pre- and postoperatively.<bold>Results: </bold>With ultrasound guidance, all PNBs were performed successfully in group P. In group P, the overall incidence and severity of PLSP decreased significantly. There were no significant differences in incisional pain, visceral pain, and analgesic requirements between the groups. Right-side diaphragmatic excursion decreased significantly in group P at 1 h postoperatively. The PFT results and respiratory discomfort assessed by a modified Borg's scale were not different significantly between the groups.<bold>Conclusion: </bold>Based on these findings, ultrasound-guided PNB can prevent or reduce the PLSP without clinically significant respiratory discomfort. [ABSTRACT FROM AUTHOR]
- Subjects :
- SHOULDER pain diagnosis
CHOLECYSTECTOMY complications
PHRENIC nerve
LAPAROSCOPIC surgery complications
NERVE block
DIAGNOSTIC ultrasonic imaging
PULMONARY function tests
POSTOPERATIVE pain prevention
AMIDES
CHOLECYSTECTOMY
COMPARATIVE studies
LAPAROSCOPIC surgery
LOCAL anesthetics
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
POSTOPERATIVE pain
RESEARCH
STATISTICAL sampling
SHOULDER pain
ULTRASONIC imaging
EVALUATION research
PAIN measurement
RANDOMIZED controlled trials
TREATMENT effectiveness
BLIND experiment
DIAGNOSIS
PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 31
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 124911683
- Full Text :
- https://doi.org/10.1007/s00464-016-5398-4